JP4094613B2 - 非金属スペーサーを有する髄内ネイル - Google Patents
非金属スペーサーを有する髄内ネイル Download PDFInfo
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- JP4094613B2 JP4094613B2 JP2005027083A JP2005027083A JP4094613B2 JP 4094613 B2 JP4094613 B2 JP 4094613B2 JP 2005027083 A JP2005027083 A JP 2005027083A JP 2005027083 A JP2005027083 A JP 2005027083A JP 4094613 B2 JP4094613 B2 JP 4094613B2
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/7241—Intramedullary pins, nails or other devices with special means of locking the nail to the bone the nail having separate elements through which screws pass
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/90—Identification means for patients or instruments, e.g. tags
- A61B90/92—Identification means for patients or instruments, e.g. tags coded with colour
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
- A61B17/8047—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers wherein the additional element surrounds the screw head in the plate hole
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00004—(bio)absorbable, (bio)resorbable, resorptive
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
- A61B50/30—Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments
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- Orthopedic Medicine & Surgery (AREA)
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- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
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- Neurology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Pathology (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
Description
本発明は、骨内に長手方向に伸びる骨髄管を有する骨の骨折を処置するために使用される、髄内ネイルに関し、そして特に、この髄内ネイルの構造、およびこの髄内ネイルをこの骨折した骨の1つ以上のフラグメントに対して固定するための方法に関する。
本発明は、骨折した骨の骨髄管内に髄内ネイルを配置することによって、骨の骨折を処置するための、髄内ネイルを包含する。ネイル構造体が、外側に少なくとも1つの窓を有して形成され、そして非金属材料のスペーサーが、この窓内に配置される。本発明の1つの局面において、この非金属のスペーサーは、生体再吸収性材料で形成され、そしてこの窓は、原動(dynamization)窓である。このネイルは、骨スクリューのような骨ファスナーとともに使用され、この骨ファスナーは、好ましくは骨と複皮質取付けにおいて、骨を横切ってスペーサー内へと進められる。この骨ファスナーは、横断面が窓より小さく、従ってこのスペーサーは、ネイルの金属構造体に対して骨ファスナーを一定の距離に置く。この窓は、その幅とは異なる長手方向長さを有し得、一方でこの骨ファスナーは、円形の断面を有する。この骨ファスナーは断面が窓およびスペーサーより小さいので、骨ファスナーの配置の際に、より大きな誤差が許容される。また、生体再吸収可なスペーサーが吸収するので、応力が、髄内ネイルを通してよりむしろ骨折部位を通して、次第に伝達される。骨ファスナーの配置、窓およびスペーサーの形状および大きさ、ならびにスペーサーの材料の全てが、骨折部位に見られる原動の種類および量にわたる設計制御を可能にする。別個のスペーサー(これは、外科医による移植の時点でネイル構造体内に配置される)の使用は、外科医が、適切なフィーチャーを有し、そして/または特定のフィーチャーの所望の治癒様式に合致するよう適切に処理および操作された、非金属のスペーサーを選択することを可能にする。
ネイル構造体であって、長手方向に延び、そして金属から形成され、該ネイル構造体の外側に規定される第一窓を有する、ネイル構造体;および
該ネイル構造体とは別個の挿入物であって、該挿入物は、非金属材料から形成され、該挿入物は、該髄内ネイルの移植の直前に該第一窓内に受容されるような大きさおよび形状にされ、該挿入物は、該第一窓内に配置される際に、該第一窓内に横断骨ファスナーを保持するためのスペーサーを提供する、挿入物、
を備える、髄内ネイル、を提供する。
前記挿入物を囲む、密封内側パウチ;および
該密封内側パウチを囲む、密封外側パウチ、
を備える。
ネイル構造体であって、長手方向に延び、そして金属から形成され、該ネイル構造体の外側に規定される第一窓を備え、該第一窓は、第一窓長手方向長さおよび第一窓幅を有し、該第一窓幅は、該第一窓長手方向長さより短い、ネイル構造体;ならびに
スペーサーであって、非金属材料から形成され、そして該第一窓を実質的に充填し、該第一窓内に横断骨ファスナーを保持するための、スペーサー、
を備える、髄内ネイル、を提供する。
金属製のネイル構造体を形成する工程であって、該ネイル構造体の外面に、第一窓が規定されている、工程;
非金属材料性の第一スペーサーを形成する工程であって、該第一スペーサーが、該第一窓に対応する外側寸法を有する、工程;および
該第一スペーサーを該第一窓に挿入する工程であって、これによって、該第一スペーサーを該ネイル構造体に対して固定する、工程、
を包含する、方法、を提供する。
ネイル構造体であって、長手方向に延び、そして金属から形成され、該ネイル構造体は、該骨髄管への挿入のための先端を有する遠位端および該遠位端の反対の近位端を有し、該ネイル構造体の遠位端の外側に第一窓が規定されており、該第一窓は、第一窓長手方向長さ、および該第一窓長手方向長さと等しくない第一窓幅を有する、ネイル構造体;ならびに
非金属材料から形成され、該第一窓内に適合するようにスライド可能に挿入可能である、第一スペーサー、
を備える、髄内ネイル、を提供する。
前記第一窓および第二窓を通じて骨ファスナーとの複皮質取り付けを可能にする、該第一窓に対向するネイル構造体の遠位端の外側に規定される第二窓であって、該第二窓は、第二窓長手方向長さ、および該第二窓長手方向長さと等しくない第二窓幅を有する、第二窓、
を備える。
前記第一窓および前記第二窓を通じて骨ファスナーでの複皮質取り付けを可能にする該第一窓に対向する該ネイル構造体の外側に規定される第二窓であって、該第二窓は、第二窓長手方向長さ、および該第二窓長手方向長さより短い第二窓幅を有する、第二窓;
該ネイル構造体の長手方向軸が二等分平面に位置するような屈曲であって、ここで該第一窓および該第二窓は、該二等分平面の対向する側に対称的に配置されている、屈曲;
該ネイル構造体において長手方向に規定されたネイル構造体カニューレ;
該ネイル構造体の遠位端を通じて、かつ該第一窓および第二窓から長手方向に離れて規定された貫通孔;ならびに
該ネイル構造体の近位端において規定されたさらなる骨取りつけ孔、を備えるネイル構造体であり;そして
生体再吸収性挿入物が、前記第一スペーサーを提供し、該生体再吸収挿入物はさらに第二スペーサーを提供し、該第一窓および第二窓を通じた骨ファスナー固定前に、該第一スペーサーは、該第一窓を充填し、そして該第二スペーサーは、該第二窓を充填し;そして
挿入カニューレは、生体再吸収性挿入物を通じて規定され、そして該ネイル構造体カニューレと整列されている。
ネイル構造体であって、長手方向に延び、そして金属から形成され、該ネイル構造体は、遠位端から該遠位端の反対の近位端へ延びる長手方向孔を有する側壁を有し、該側壁は、該側壁を通じて延びる第一窓を有し、該第一窓は第一窓形状を有する、ネイル構造体;ならびに
非金属材料から形成され、該ネイル構造体から空間を隔てた第一スペーサーであって、該第一スペーサーは、該第一窓形状に相当する外部寸法を有し、その結果該第一スペーサーは、該第一窓内中にスライド可能に挿入可能であり、そして該第一窓に受容されて、該ネイル構造体に対して該第一スペーサーが固定される、第一スペーサー、
を備える、髄内ネイルアセンブリ、を提供する。
非金属材料から形成される第二スペーサーであって、該第二スペーサーは、該第二窓形状に相当する外部寸法を有し、該第一スペーサーおよび該第二スペーサーは、該ネイル構造体の片側から該第一窓および第二窓の両方に配置され得る単一挿入物によって形成されている、第二スペーサー、
を備える。
をさらに備える。
ネイル構造体であって、長手方向に延び、そして金属から形成され、該ネイル構造体は、該骨髄管に挿入するための先端を有する遠位端、および該ネイル構造体の外側に規定される第一窓を有する、該遠位端と対向する近位端を有する、ネイル構造体;および
該第一窓内に非金属材料から形成された第一スペーサーであって、該第一スペーサーは、該第一スペーサーの中心に向かって傾斜付けされた該第一窓に露出された表面輪郭を有する、第一スペーサー、
を備える、髄内ネイル、を提供する。
ネイル構造体であって、長手方向に延び、そして金属から形成され、該ネイル構造体は、該骨髄管に挿入するための先端を有する遠位端、および該遠位端と反対の近位端を有し、該ネイル構造体は、選択されたスペーサーの露出のためのネイル構造体の外側に規定された少なくとも1つの窓を有する、ネイル構造体;
非金属材料で形成された第一スペーサーであって、該第一スペーサーは、該ネイル構造体を通じ、かつ該第一スペーサーを通じた、骨ファスナーでの横断締め付けのための露出位置において該ネイル構造体に受容されるようにサイズ決めされている、第一スペーサー;ならびに
該第一スペーサーから隔てられて形成された第二スペーサーであって、該第二スペーサーは、該ネイル構造体を通じ、かつ該第二スペーサーを通じた、骨ファスナーでの横断締め付けのための露出位置において該ネイル構造体に受容されるようにサイズ決めされており、該第二スペーサーは、該第一スペーサーとは異なる機械的処置特性または化学的処置特性を有する、第二スペーサー、
を備える、髄内ネイルアセンブリ、を提供する。
本発明による髄内ネイル20は、近位端24、遠位端26およびシャフト28を有する、ネイル構造体22を備え、ここで「近位」および「遠位」とは、ネイル20が骨に挿入されることが意図される方向に従って、規定される。当該分野において公知であるように、近位端24、遠位端26およびシャフト28の寸法は、ネイルの要求される強度および髄内ネイルの意図される用途に基づいて、選択され得る。図1〜21に図示するネイル20は、一般に、その他の点では健康である成人の大腿骨の内部に向けて、骨折を処置するための大きさおよび形状にされる。所望であれば、ネイル20は、種々の大きさの患者の大腿骨にフィットするための種々の大きさのネイルを有するか、および/または種々の種類の大腿骨の状態もしくは種々の種類の大腿骨折にフィットするための種々の大きさのネイルを有するか、および/または種々の他の骨にフィットするための種々の大きさのネイルをさらに有する、キットに含まれ得る。例えば、示される大腿ネイル20の長さは、約10インチと20インチとの間で必要であるように、選択され得る。
Claims (2)
- 長手方向に延びる骨髄管を有する骨の骨折を処置するための髄内ネイルであって、以下:
ネイル構造体であって、長手方向に延び、そして金属から形成され、該ネイル構造体の外側に規定される第一窓を有する、ネイル構造体;および
該ネイル構造体とは別個の挿入物であって、該挿入物は、生体再吸収性材料から形成され、該挿入物は、該髄内ネイルの移植の直前に該第一窓内に受容されるような大きさおよび形状にされ、該挿入物は、該第一窓内に配置される際に、該第一窓内に横断骨ファスナーを保持するためのスペーサーを提供する、挿入物、
を備え、
前記挿入物が、該挿入物の外面に干渉プロフィールを有して形成され、その結果、該挿入物が、前記髄内ネイルの前記第一窓にプレスばめされて受容され、ここで該干渉プロフィールが、該挿入物の外面を異なって局所的に覆う圧迫応力で、該髄内ネイルと接触し、
前記干渉プロフィールが、縁部を有し、該縁部が、該髄内ネイルに接触し、そして前記挿入物の周囲に部分的に延び、
前記縁部が、前記挿入物の長手方向長さを増加するように前記挿入物の長手方向の端部に設けらている、髄内ネイル。 - 前記第一窓が、前記髄内ネイル内に長手方向に延び、ここで、前記挿入物が、長手方向に長さを、そして該長さを横切って幅を有し、ここで、前記干渉プロフィールが、該挿入物と該窓との間で、該長手方向より該横切る方向において、大きな干渉を有する、請求項1に記載の髄内ネイル。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/289,324 US6296645B1 (en) | 1999-04-09 | 1999-04-09 | Intramedullary nail with non-metal spacers |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2000610358A Division JP3701566B2 (ja) | 1999-04-09 | 2000-04-10 | 非金属スペーサーを有する髄内ネイル |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2005118603A JP2005118603A (ja) | 2005-05-12 |
JP4094613B2 true JP4094613B2 (ja) | 2008-06-04 |
Family
ID=23111042
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2000610358A Expired - Fee Related JP3701566B2 (ja) | 1999-04-09 | 2000-04-10 | 非金属スペーサーを有する髄内ネイル |
JP2005027083A Expired - Lifetime JP4094613B2 (ja) | 1999-04-09 | 2005-02-02 | 非金属スペーサーを有する髄内ネイル |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2000610358A Expired - Fee Related JP3701566B2 (ja) | 1999-04-09 | 2000-04-10 | 非金属スペーサーを有する髄内ネイル |
Country Status (5)
Country | Link |
---|---|
US (3) | US6296645B1 (ja) |
EP (1) | EP1168970A4 (ja) |
JP (2) | JP3701566B2 (ja) |
AU (1) | AU760855B2 (ja) |
WO (1) | WO2000061018A1 (ja) |
Families Citing this family (143)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1342453B1 (en) * | 1997-03-19 | 2005-08-24 | Stryker Trauma GmbH | Modular intramedullary nail |
US6296645B1 (en) * | 1999-04-09 | 2001-10-02 | Depuy Orthopaedics, Inc. | Intramedullary nail with non-metal spacers |
US6221074B1 (en) * | 1999-06-10 | 2001-04-24 | Orthodyne, Inc. | Femoral intramedullary rod system |
US6527775B1 (en) | 2000-09-22 | 2003-03-04 | Piper Medical, Inc. | Intramedullary interlocking fixation device for the distal radius |
US7547307B2 (en) * | 2001-02-27 | 2009-06-16 | Smith & Nephew, Inc. | Computer assisted knee arthroplasty instrumentation, systems, and processes |
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-
1999
- 1999-04-09 US US09/289,324 patent/US6296645B1/en not_active Expired - Lifetime
-
2000
- 2000-04-10 JP JP2000610358A patent/JP3701566B2/ja not_active Expired - Fee Related
- 2000-04-10 WO PCT/US2000/009582 patent/WO2000061018A1/en active Application Filing
- 2000-04-10 EP EP00922022A patent/EP1168970A4/en not_active Withdrawn
- 2000-04-10 AU AU42266/00A patent/AU760855B2/en not_active Ceased
- 2000-05-22 US US09/575,764 patent/US6709436B1/en not_active Expired - Lifetime
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2001
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Also Published As
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WO2000061018A1 (en) | 2000-10-19 |
US6296645B1 (en) | 2001-10-02 |
US20020029041A1 (en) | 2002-03-07 |
EP1168970A4 (en) | 2008-11-26 |
JP2005118603A (ja) | 2005-05-12 |
JP2002540884A (ja) | 2002-12-03 |
AU4226600A (en) | 2000-11-14 |
AU760855B2 (en) | 2003-05-22 |
WO2000061018A9 (en) | 2002-06-06 |
JP3701566B2 (ja) | 2005-09-28 |
US6786908B2 (en) | 2004-09-07 |
US6709436B1 (en) | 2004-03-23 |
EP1168970A1 (en) | 2002-01-09 |
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